FIGURE 1. PAHO Member States that have fully, partially or have not achieved each of the five objectives to eliminate IP-TFA in 2021, and baseline status in 2018.

PAHO, Pan American Health Organization; IP-TFA, industrially produced trans fatty acids

^a Fully achieved: countries that have implemented all indicators within an objective, as of 31 December 2021. However, for Objective 1.1-Law Limiting IP-TFA, a country is considered to have fully achieved this objective if either PHOs for human consumption are prohibited from the food supply and/or if any food product with IP-TFA content in excess of 2% total fat is prohibited.

^b Partially achieved: countries that have enacted an indicator within an objective but have not started the implementation yet, as of 31 December 2021 and if less than all of the indicators within an objective are fully implemented, as of 31 December 2021.

^c Not achieved: countries that have no indicators within an objective achieved, as of 31 December 2021.

^d Missing (response inferred): countries that did not respond to the survey; data were inferred from other sources.

^e Each of the objectives have different indicators to determine if countries have achieved the objective. The indicators for objective 1.1 are: 1.1.1 Countries and territories that prohibit the production, importation, distribution, sale, and use of PHO in foods for human consumption; 1.1.2 Countries and territories that prohibit the production, importation, distribution, sale, and use of any food product with IP-TFA content in excess of 2% of total fat; and 1.1.3 Countries and territories that prohibit the production, importation, distribution, sale, and use of PHO in foods for human consumption and prohibit the production, importation, distribution, sale, and use of any food product with IP-TFA content in excess of 2% of total fat. Indicators for objective 1.2 are: 1.2.1 Countries and territories that require standardized labeling of PHO in ingredient lists; 1.2.2 Countries and territories that require standardized quantitative declaration of TFA content; 1.2.3 Countries and territories that require front-of-package labeling that allows for quick and easy interpretation of saturated fat content; 1.2.4 Countries and territories that require front-of-package labeling that allows for quick and easy interpretation of TFA content; and 1.2.5 Countries and territories that establish requirements for the use of claims such as “trans fat free” or “reduced trans fat.” Indicators for objective 2.1 are: 2.1.1 Countries and territories that have defined a plan to ensure compliance consistent with their adopted policy; 2.1.2 Countries and territories that have data on enforcement actions; 2.1.3 Countries and territories that define and implement practices to ensure compliance of imported foods; and 2.1.4 Countries and territories with assessment data on compliance levels for PHO or IP-TFA content. Indicators for objective 3.1 are: 3.1.1 Countries and territories with at least one publicly available pre- regulation national assessment of foods that are sources of IP-TFA, and if possible, the quantity of IP-TFA in these products; 3.1.2 Countries and territories with at least one post-regulation national assessment of foods that are sources of IP-TFA, and if possible, the quantity of IP-TFA in these products; 3.1.3 Countries and territories with at least one pre-regulation national assessment of saturated fat levels in products identified as significant sources of IP-TFA; and 3.1.4 Countries and territories with at least one post-regulation national assessment of saturated fat levels in products identified as significant sources of IP-TFA intake prior to regulation. Indicators for objective 4.1 are: 4.1.1 Countries and territories that implement education and communication strategies for the general public on the negative health impacts of TFA and benefits of the elimination policies and 4.1.2 Countries and territories that implement education and communication strategies for food producers, importers, and retailers on the new policies and how to comply.

^f Baseline: countries that have fully achieved or partially achieved the objective.

^g Progress: countries that have fully achieved or partially achieved the objective.

Source: Prepared by the authors from the study results.